How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $4,365.16 Median $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $147.91 Typical High $269.15 | Professional | None | $64.57 | $147.91 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $177.83 Typical High $346.74 | Professional | None | $72.44 | $177.83 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $446.68 Typical High $794.33 | Facility | None | $245.47 | $446.68 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $213.80 Typical High $323.59 | Professional | None | $97.72 | $213.80 | $323.59 |
ConnectiCare Setting Professional Modifier None Typical Low $208.93 Median $257.04 Typical High $398.11 | Professional | None | $208.93 | $257.04 | $398.11 |
Health New England Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
United Setting Professional Modifier None Typical Low $72.44 Median $181.97 Typical High $478.63 | Professional | None | $72.44 | $181.97 | $478.63 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $63.10 Typical High $131.83 | Professional | 52 · Reduced service | $32.36 | $63.10 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $25.12 Typical High $53.70 | Professional | 53 · Discontinued | $12.88 | $25.12 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $95.50 Typical High $199.53 | Professional | 54 · Surgery only | $48.98 | $95.50 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $19.05 Typical High $39.81 | Professional | 55 · Aftercare only | $9.77 | $19.05 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $12.59 Typical High $26.92 | Professional | 56 · Pre-op care only | $6.46 | $12.59 | $26.92 |
Where Connecticut sits
The same service costs 2.9 times more in Washington than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Connecticut· 18th of 51
$186
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.